Summer Club NDIS Agreement Form ⋆ Rainbow Club

Rainbow Club Member's First Name

Member's DOB (dd-mm-yyyy)

NDIS Participant Number

Mobile

Rainbow Club Member's Last Name

Summer Club Location

Participant’s Parent or Guardian

Email Address

Who is managing this plan?

Self Managed

NDIA Managed

Registered Plan Manager

Plan Management Provider

Plan Manager Contact Person (if known)

Plan Manager's Contact Number

Plan Manager's Email Address

Start Date of Plan

End Date of Plan

Fees are $190 for our Rainbow Summer Club membership

I confirm that I have $190 available in this plan for Rainbow Summer Club Membership

I authorise Rainbow Club to make a Service Booking on the NDIS portal for this period.

Please indicate which budget you would like the funds to be taken from

If Other, please specify

Agreement Signatures

Yes -The participant’s parent/guardian agrees to the terms and conditions in this Service Agreement and understands that Rainbow Club is a charity that provides a social swimming club and individualised swimming lessons to children with a disability to ensure that they are safe in the water.

I would like to opt out of being part of any audits.

I give Rainbow Club permission to take photographs and / or video of my child to be used for media purposes.

By submitting this form, I understand that the information I have supplied in my application will be used by Rainbow Club, its employees and agents with the purpose of providing swimming lessons for my child.

The NDIS and this Service Agreement

This Service Agreement is made for the purpose of funding Rainbow Summer Club Membership subscription under the participant’s NDIS plan.
Rainbow Club will endeavour to meet the cultural and diverse needs of members within the constraints of the pools we use and the safety of other members.

Responsibilities of the participant/participant’s representative

The subscription is for 5 days of intensive lessons, regardless of any absences during the week. No refunds will be provided.
Participants are required to wear swimmers and rash vests and, if necessary, Swim Nappies. Participants who have yet to be toilet trained should have both a Swim Nappy and a Happy Nappy to minimize the effects of accidents which could cause closure of the pool.
Parents are responsible for their own children when they are not in the pool with a Rainbow Club teacher.

Responsibilities of Rainbow Club
Rainbow Club agrees to:

Only employ teachers who have relevant swim teaching qualifications and verified Working With Children checks.
Provide 5 consecutive days of individualised half hour lessons in the Summer Club program.
We will notify you in the event of an unforeseen access problem or accident in the pool – Rainbow Clubs will endeavour to provide a make-up session but cannot always promise this will happen as the subscription amount may not cover the costs, the pool may not be available or teacher availability may be limited.
Communicate openly and honestly in a timely manner
Treat the participant with courtesy and respect and meet the cultural needs of the participant.
Give the participant or the participant’s representative information about providing feedback or complaints and how they will be managed.
Listen to the participant’s feedback and resolve problems quickly.
Protect the participant’s privacy and confidential information.

Incidents, feedback, compliments and complaints

In the event of an incident, please advise the Lead Teacher of your Summer Club. The General Manager has responsibility for ensuring all Incidents are managed appropriately and any action will depend on the nature of the incident.
If the participant wishes to give feedback to Rainbow Cub, the participant can talk to the Summer Club Coordinator or fill out a feedback form.
If the participant is not happy with their Rainbow Club experience and wishes to make a complaint, the participant can talk to the Summer Club Coordinator or provide feedback here.
Alternatively, if the participant is not satisfied or does not want to talk to the Summer Club Coordinator, the participant can contact the General Manager of Rainbow Club Australia at info@myrainbowclub.org.au or by calling 0431097813.
At any time the participant may bring their complaint to the NDIS Commission (https://www.ndiscommission.gov.au/about/complaints) or by phone at 1800 035 544
Further details of this policy and the procedures are outlined on our website.

Summer Club NDIS Agreement Form

Recent Posts

Post Categories